I just want to really reflect on how its been for me. What I've learnt and how I've learnt to cope. It would be great if readers could also share ideas and experiences. I think sharing helps us to understand and learn new skills and support each other.
One of the hardest experiences I've ever had to deal with was fairly recently. A 4 week old baby came in to ED with traumatic ,inflicted injuries.My role was as a resus nurse alongside a junior nurse from Paeds ED and two adult resus nurses. I was so lucky to have two of my most trusted and experienced Paeds ED Consultants there too. The baby was so sick and the potential for serious, life long damage was very real and unknown at that time. The family were present and at that point we had no idea who had inflicted the injuries-we just knew this baby had injuires that were non-accidental. It was a tough situation for all of us. At one point, while I was standing by his infant warmer, the Consultant came over and put his arm around me. There were no words.
The baby was stabilised and transferred to PICU(He actually did really well and was discharged into the care of a Foster Carer a few weeks later)
We had a team debrief that same day and all team members involved(there were a couple of nursing students there too) were present. We were able to ask questions of the Consultant and also reflect on how we felt and how we would deal with these feelings over the next few days. I drove home that night absolutely drained. I was exhausted. We had a birthday dinner for a member of our family planned at our house and ,although I definitely didn't feel like entertaining,I put on my best smile and carried on. It wasn't until 11 pm that I finally was able to talk to my hubby about what had happened and let him know how hard the resus had been.
For the next couple of days that baby weighed heavily on my mind. It was good to able to chat to colleagues about what had happened and gain support from them.I reflected on my role in that resus. Whilst I was there to nurse the baby,I felt a big part of my role ,as the most senior nurse,was to support the staff. I was working alongside a junior RN,who was excellent,but still only very young and not long out of college. I was also working with some very experienced ED nurses but who had not had much experience with paediatric trauma and most definitely not with child protection. I allowed the junior RN to lead the care and I supported her. We debriefed together and shared our experiences with each other.
I was able to continue on after a few days with no problems. I continued to be compassionate,good nurse. I was able to relax at home and laugh and live(and love) my life.
In previous blog posts I have alluded to different times in my career where I maybe haven't been able to cope as well. I had experiences in paediatric oncology that have been difficult and actually had a profound affect on my home life and nursing career.At one point I was so drained I left nursing nursing for a while. How is it that I can cope with some terrible situations much better now?
I think experience does play a big part. I think you learn alot about yourself when you are a nurse. I am older and can compartmentalise things much better. I can literally mentally 'put things in boxes' to store away for reflection another time if I need to. That doesn't mean I don't deal with issues ,its just sometimes,when you're in 'the moment' like a resus or just half way through your shift, you need to be able to continue on and not stop to think .
On reflection, when I look back at some of the most tricky resus's or situations, I can remember having senior nurses there to support and guide me. In my early career I remember two particularly difficult situations with very sick children(one died,one survived) and on each occasion, the ward sister(NUM) was present. They let me run the resus but supported me all the way and helped me reflect afterwards. I think as senior nurses this is absolutely one of our most important roles- support not take over. Guide not instruct.
I have been lucky throughout my career to be surrounded by great 'teams'. That is work colleagues,friends and family. Having a good team around is so helpful in maintaining sanity. We all know clinicians can laugh(have black humour) even in the most tricky situations. Nurses provide a great sounding board. I cannot talk to friends and family about some of the things we see and do like I can talk to my colleagues or nursing friends. No-one understands like a nurse.
I also think having something else in your life helps too. I now have two kids and a busy life outside work. When I was a new grad I was consumed by work. That doesn't mean that you have to have kids or family to be emotionally resilient but its so helpful to have 'something' else. It can be friends,pets,volunteering or a hobby-anything just so that work is not all you are. I honestly think this makes you a better nurse.
Learning to leave work behind is really important. One of my very first ward Sisters used to tell us to leave work behind as we walked over the hospital crest painted on the floor in the hospital foyer. Its a good tip. I now like to have the journey home (in the car or by train)to reflect on my day. Of course some days its easier that others. Sometimes it just takes a little more time.I've also learned that's OK too.
Having fun at work is important . There is nothing wrong with enjoying a lovely morning tea with staff or laughing with patients. I once had a mum of a child with cancer say to me " How can you nurses be so happy all the time when you work here? Why aren't you crying?" My answer ? "Because how is crying all the time going to help our patients? How do you think we could come to work and care for your little boy if we were crying all the time ?" Of course there are times when I'm so overwhelmed at work I do cry. Not weeping and hysterical but maybe teary. When you see a baby being put in a body bag as you stand alongside their parents, how can you not tear up ?
I once asked my husband to tell me if it ever seemed that to me a child dying was normal. That would be the day I resigned. I have worked with nurses that are so 'hardened'. I never ever want to be like that. I want to retain my humanity.I count my blessings every day. I'm so grateful for all that I have. Nursing has done that for me. Nursing puts life into perspective.
Let me know what you think. Its good to talk..........
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